scholarly journals High-Sensitivity Cardiac Troponin-T and N-Terminal Prohormone of B-Type Natriuretic Peptide in Relation to Cardiovascular Outcomes in Type 1 Diabetes

2020 ◽  
Author(s):  
Tina Costacou ◽  
Amy K. Saenger ◽  
Trevor J. Orchard
Keyword(s):  
Myocardial Infarction ◽  
Type 1 Diabetes ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Coronary Revascularization ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cox Models

Objective: High-sensitivity cardiac Troponin-T (hs-cTnT) and N-terminal pro B-Type natriuretic peptide (NT-proBNP), biomarkers of cardiovascular disease (CVD) and heart failure, respectively, have not been widely studied in type 1 diabetes (T1D). We evaluated whether their assessment in T1D enhances the prediction of CVD and major atherosclerotic cardiovascular events (MACE). <p> </p> <p>Research Design and Methods: hs-cTnT and NT-proBNP were analyzed on the Roche Cobas E601 utilizing the first available stored specimen (n=581; mean age 29 and duration 21 years). CVD was defined as CVD death, myocardial infarction, coronary revascularization, angina, ischemia, or stroke and MACE as CVD death, myocardial infarction, or stroke.</p> <p> </p> <p>Results: Median hs-cTnT (5.0 ng/L, IQR: <3.0, 10.0) was higher among men (p<0.0001), whereas median NT-proBNP (22.0 ng/L; 7.0, 61.0) did not differ by sex. In Cox models, log hs-cTnT (HR=1.38, p=0.0006) and log NT-proBNP (HR=1.24, p=0.0001) independently predicted CVD during 21 years of follow-up. However, their addition to models either singly or together did not significantly improve CVD prediction. Furthermore, a marginally significant sex interaction was observed (p=0.06), indicating that hs-cTnT’s prediction was limited to men. hs-cTnT and NT-proBNP also predicted MACE, although only NT-proBNP remained significant (HR=1.27, p=0.0009) when the biomarkers were included in a model simultaneously. Nonetheless, their addition to multivariable models did not enhance MACE prediction.</p> <p> </p> <p> </p> <p>Conclusions: Sex differences were observed in the concentration and predictive ability of hs-cTnT and NT-proBNP in T1D. Overall, their addition to traditional risk factor models increased the area under the curve for neither CVD nor MACE.</p>

scholarly journals High-Sensitivity Cardiac Troponin-T and N-Terminal Prohormone of B-Type Natriuretic Peptide in Relation to Cardiovascular Outcomes in Type 1 Diabetes

2020 ◽  
Author(s):  
Tina Costacou ◽  
Amy K. Saenger ◽  
Trevor J. Orchard
Keyword(s):  
Myocardial Infarction ◽  
Type 1 Diabetes ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Coronary Revascularization ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cox Models

Objective: High-sensitivity cardiac Troponin-T (hs-cTnT) and N-terminal pro B-Type natriuretic peptide (NT-proBNP), biomarkers of cardiovascular disease (CVD) and heart failure, respectively, have not been widely studied in type 1 diabetes (T1D). We evaluated whether their assessment in T1D enhances the prediction of CVD and major atherosclerotic cardiovascular events (MACE). <p> </p> <p>Research Design and Methods: hs-cTnT and NT-proBNP were analyzed on the Roche Cobas E601 utilizing the first available stored specimen (n=581; mean age 29 and duration 21 years). CVD was defined as CVD death, myocardial infarction, coronary revascularization, angina, ischemia, or stroke and MACE as CVD death, myocardial infarction, or stroke.</p> <p> </p> <p>Results: Median hs-cTnT (5.0 ng/L, IQR: <3.0, 10.0) was higher among men (p<0.0001), whereas median NT-proBNP (22.0 ng/L; 7.0, 61.0) did not differ by sex. In Cox models, log hs-cTnT (HR=1.38, p=0.0006) and log NT-proBNP (HR=1.24, p=0.0001) independently predicted CVD during 21 years of follow-up. However, their addition to models either singly or together did not significantly improve CVD prediction. Furthermore, a marginally significant sex interaction was observed (p=0.06), indicating that hs-cTnT’s prediction was limited to men. hs-cTnT and NT-proBNP also predicted MACE, although only NT-proBNP remained significant (HR=1.27, p=0.0009) when the biomarkers were included in a model simultaneously. Nonetheless, their addition to multivariable models did not enhance MACE prediction.</p> <p> </p> <p> </p> <p>Conclusions: Sex differences were observed in the concentration and predictive ability of hs-cTnT and NT-proBNP in T1D. Overall, their addition to traditional risk factor models increased the area under the curve for neither CVD nor MACE.</p>

scholarly journals High-sensitivity cardiac Troponin-T and N-terminal pro B-Type Natriuretic Peptide in relation to cardiovascular outcomes in type 1 diabetes

2020 ◽  
Author(s):  
Tina Costacou ◽  
Amy K. Saenger ◽  
Trevor J. Orchard
Keyword(s):  
Myocardial Infarction ◽  
Type 1 Diabetes ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Coronary Revascularization ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Cox Models

Objective: High-sensitivity cardiac Troponin-T (hs-cTnT) and N-terminal pro B-Type natriuretic peptide (NT-proBNP), biomarkers of cardiovascular disease (CVD) and heart failure, respectively, have not been widely studied in type 1 diabetes (T1D). We evaluated whether their assessment in T1D enhances the prediction of CVD and major atherosclerotic cardiovascular events (MACE). <p> </p> <p>Research Design and Methods: hs-cTnT and NT-proBNP were analyzed on the Roche Cobas E601 utilizing the first available stored specimen (n=581; mean age 29 and duration 21 years). CVD was defined as CVD death, myocardial infarction, coronary revascularization, angina, ischemia, or stroke and MACE as CVD death, myocardial infarction, or stroke.</p> <p> </p> <p>Results: Median hs-cTnT (5.0 ng/L, IQR: <3.0, 10.0) was higher among men (p<0.0001), whereas median NT-proBNP (22.0 ng/L; 7.0, 61.0) did not differ by sex. In Cox models, log hs-cTnT (HR=1.38, p=0.0006) and log NT-proBNP (HR=1.24, p=0.0001) independently predicted CVD during 21 years of follow-up. However, their addition to models either singly or together did not significantly improve CVD prediction. Furthermore, a marginally significant sex interaction was observed (p=0.06), indicating that hs-cTnT’s prediction was limited to men. hs-cTnT and NT-proBNP also predicted MACE, although only NT-proBNP remained significant (HR=1.27, p=0.0009) when the biomarkers were included in a model simultaneously. Nonetheless, their addition to multivariable models did not enhance MACE prediction.</p> <p> </p> <p> </p> <p>Conclusions: Sex differences were observed in the concentration and predictive ability of hs-cTnT and NT-proBNP in T1D. Overall, their addition to traditional risk factor models increased the area under the curve for neither CVD nor MACE.</p>

scholarly journals Premorbid levels of high-sensitivity cardiac troponin T and natriuretic peptide and prognosis after incident myocardial infarction

2019 ◽  
Vol 216 ◽  
pp. 62-73 ◽  
Author(s):  
Yejin Mok ◽  
Yingying Sang ◽  
Shoshana H. Ballew ◽  
Ron C. Hoogeveen ◽  
Christie M. Ballantyne ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

NT-proBNP, hs-cTnT, and CRP predict the risk of cardiopulmonary outcomes in systemic sclerosis: Findings from the Canadian Scleroderma Research Group

2021 ◽  
pp. 239719832110406
Author(s):  
Mayank Jha ◽  
Mianbo Wang ◽  
Russell Steele ◽  
Murray Baron ◽  
Marvin J Fritzler ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

Objective: The aim of this study was to determine the independent value of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein to predict onset of cardiopulmonary disease in a large, multi-center systemic sclerosis cohort followed prospectively. Methods: Subjects from the Canadian Scleroderma Research Group registry with data on N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were identified. Outcomes of interest were death, systolic dysfunction (left ventricular ejection fraction < 50% or medications for heart failure), pulmonary arterial hypertension by right heart catheterization, pulmonary hypertension by cardiac echocardiography (systolic pulmonary artery pressures ⩾ 45 mmHg), arrhythmias (pacemaker/implantable cardiac defibrillator or anti-arrhythmic medications), and interstitial lung disease. Multivariate Cox proportional hazard models were generated for each outcome. Results: A total of 675 subjects were included with a mean follow-up of 3.0 ± 1.8 years. Subjects were predominantly women (88.4%) with mean age of 58.2 ± 11.3 years and mean disease duration of 13.7 ± 9.1 years. One hundred and one (101, 15%) subjects died during follow-up, 37 (6.4 %) developed systolic dysfunction, 18 (2.9%) arrhythmias, 34 (5.1%) pulmonary arterial hypertension, 43 (7.3%) pulmonary hypertension, and 48 (12.3%) interstitial lung disease. In multivariate analyses, elevated levels of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were associated with increased risk of death, while elevated levels of N-terminal pro b-type natriuretic peptide and C-reactive protein were associated with increased risk of developing pulmonary hypertension. Conclusion: In systemic sclerosis, N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein have independent predictive value for death and pulmonary hypertension. A larger study would be required to determine the predictive value of these biomarkers for less common systemic sclerosis outcomes.

scholarly journals Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay

2015 ◽  
Vol 187 (8) ◽  
pp. E243-E252 ◽  
Author(s):  
Tobias Reichlin ◽  
Raphael Twerenbold ◽  
Karin Wildi ◽  
Maria Rubini Gimenez ◽  
Nathalie Bergsma ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T ◽  
Rule Out
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